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09:02
Immunoglobulin Gene Sequence Analysis In Chronic Lymphocytic Leukemia: From Patient Material To Sequence Interpretation
Published on: November 26, 2018
Zosteriform B-cell chronic lymphocytic leukemia infiltration.
Joana Antunes1, David Pacheco, Rita Travassos
1Serviço de Dermatologia, Hospital de Santa Maria, Lisbon, Portugal.
Dermatology Online Journal
|October 6, 2011
Summary
Cutaneous infiltration by B-cell chronic lymphocytic leukemia (B-CLL) presented as a rare zosteriform rash. Treatment targeting the leukemia led to complete resolution of skin lesions and symptoms.
Area of Science:
- Dermatology
- Hematology
- Oncology
Background:
- Cutaneous leukemic infiltration is an uncommon sign of disease progression.
- B-cell chronic lymphocytic leukemia (B-CLL) can manifest in the skin, though rarely with a zosteriform pattern.
Observation:
- A 77-year-old female with B-CLL presented with a 4-week history of pruritic, erythematous papules on her left hemithorax in a C6 dermatome distribution.
- Initial treatment for viral infections (Valacyclovir, Acyclovir) was ineffective.
- Tzanck smear and PCR for VZV/HSV were negative.
Findings:
- Histopathology revealed a B-CLL infiltrate (CD3+, CD20+).
- Cytogenetic analysis confirmed bone marrow alterations consistent with cutaneous B-CLL infiltration.
- The patient responded well to chemotherapy with chlorambucil and IV immunoglobulin, achieving complete regression of lesions and pruritus.
Implications:
- This case highlights a rare presentation of cutaneous B-CLL infiltration mimicking herpes zoster.
- It underscores the importance of considering underlying hematologic malignancy in atypical dermatological presentations.
- Therapeutic strategies should focus on treating the primary leukemia for effective management of cutaneous manifestations.
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